For most of the last century, chronic wound care was a practice of passive techniques, designed to prevent the progression of the wound. In the last decade, however, advanced techniques have focused on improving the wound at the molecular level to accelerate wound healing. Successful modalities include tissue-engineered products, hyperbaric oxygen, negative pressure therapy, electrical stimulation, and recombinant growth factors. This shift in the treatment of wound care saw the development of a recombinant human platelet-derived growth factor, becaplermin, which stimulates granulation and increases the incidence of complete wound closure. Another product is oxidized regenerated cellulose/collagen, which protects growth factors and granulation tissue by inhibiting wound proteases. Used together, an optimal environment for wound healing can be created.
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Prehospital Interventions to Reduce Discomfort From Spinal Immobilization in Adult Trauma Patients: A Scoping Review.
J Trauma Nurs
January 2025
Author Affiliations: Department of Community Medicine, Information and Health Decision Sciences, University of Porto, Porto, Portugal (Dr Mota); Health School, Polytechnic Institute of Viseu, Viseu, Portugal (Drs Mota, Santos, and Cunha); Health Sciences Research Unit: Nursing (UICISA: E), Coimbra, Portugal (Drs Mota and Cunha); CINTESIS@RISE - Center for Health Technology and Services Research, University of Porto, Porto, Portugal (Drs Mota and Santos); Academic Clinical Centre of Beiras, Covilhã, Portugal (Drs Mota and Cunha); Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal (Drs Melo and Santos); Portugal Centre for Evidence-Based Practice: A Joanna Briggs Institute Centre of Excellence, Coimbra, Portugal (Dr Santos); Hospital São Teotónio, Tondela Viseu Hospital Centre, Viseu, Portugal (Dr Abrantes); Santa Casa da Misericórdia de Seia, Seia, Portugal (Dr Monteiro); and Nursing School of Porto, Porto, Portugal (Dr Santos).
Background: Spinal immobilization, a widely used trauma prehospital intervention, is known to cause discomfort, yet little is known about interventions to reduce this discomfort.
Objective: This scoping review aims to evaluate prehospital interventions to reduce discomfort from spinal immobilization in adult trauma patients.
Method: This scoping review assessed prehospital pharmacological and nonpharmacological interventions to address discomfort from spinal immobilization in adult trauma patients.
Trauma Patient Transitional Work: A Multidisciplinary Feasibility Survey of Planned Behavior Elements.
J Trauma Nurs
January 2025
Author Affiliations: Penn Medicine, Department of Advanced Practice & Trauma Surgical Critical Care (Dr Saucier), Biostatistics, Hearing, & Speech, Ingram Cancer Center, Vanderbilt University School of Medicine (Dr Dietrich), School of Nursing, Vanderbilt University (Drs Maxwell and Minnick), Nashville, Tennessee; David E. Longnecker Associate Professor of Anesthesiology and Critical Care (Dr Lane-Fall), Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; and Surgical Service Line (Dr Messing), Inova Health System, Falls Church, Virginia.
Background: Patient transitions in critical care require coordination across provider roles and rely on the quality of providers' actions to ensure safety. Studying the behavior of providers who transition patients in critical care may guide future interventions that ultimately improve patient safety in this setting.
Objective: To establish the feasibility of using the Theory of Planned Behavior in a trauma environment and to describe provider behavior elements during trauma patient transfers (de-escalations) to non-critical care units.
Pleural Space Management in Thoracic Trauma.
J Orthop Trauma
December 2024
Section of Acute Care Surgery, Department of General Surgery, Stanford University, Stanford, CA.
Thoracic injuries are common, occurring in up to 60% of polytrauma patients and represent 25% of trauma deaths. Thoracic trauma frequently involves injury to the pleural space resulting in hemothorax and pneumothorax-effective management of the pleural space is essential. Reviewed in this article is management of the pleural space in chest wall trauma (including pneumothorax and hemothorax), and chest tube placement, indications for video-assisted thoracoscopic surgery, management, and complications.
View Article and Find Full Text PDFInjury Patterns and Surgical Approaches.
J Orthop Trauma
December 2024
Department of Orthopaedic Surgery, University of Missouri - Columbia, Missouri Orthopaedic Institute, Columbia, MO.
Effective management of bony and cartilaginous thoracic injury is a vital part of the care of the polytraumatized patient. Commonly because of high-energy accidents including motor vehicle collisions and falls, these patients routinely require multidisciplinary care and surgical intervention. As our understanding of unstable chest wall injuries and pulmonary sequelae of the injury grows, it is imperative that injury patterns and surgical approaches become familiar to the orthopaedic trauma-trained surgeon.
View Article and Find Full Text PDFBest Available Outcomes Evidence Informing Standard of Care.
J Orthop Trauma
December 2024
Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN; and.
Although nonoperative management is the mainstay for rib fracture treatment, surgical stabilization of rib fractures is becoming more common. Recently, the number of high-quality studies on management of rib fractures has also increased. The primary purpose of this review is to analyze the currently available prospective randomized studies on the management of rib fractures.
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